Rural Health
Resources by Topic: Medicare
Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, Mathematica
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Most People in the Most Rural Counties Get Medicare Coverage from Traditional Medicare
Examines the percentage of eligible Medicare beneficiaries with traditional Medicare versus Medicare Advantage at the county level in 2024. Compares type of Medicare coverage by rural non-adjacent, rural adjacent, and urban county classification.
Author(s): Jeannie Fuglesten Biniek, Meredith Freed, Nolan Sroczynski, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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Examines the percentage of eligible Medicare beneficiaries with traditional Medicare versus Medicare Advantage at the county level in 2024. Compares type of Medicare coverage by rural non-adjacent, rural adjacent, and urban county classification.
Author(s): Jeannie Fuglesten Biniek, Meredith Freed, Nolan Sroczynski, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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10 Things to Know About Rural Hospitals
Presents information and data on rural hospitals and rural hospital finances. Compares insurance coverage of discharges and births, margins, and the impact of Medicaid expansion by hospitals' rural and urban location. Includes information on rural hospital closures and Medicare special payment designations for rural hospitals. Discusses the potential impacts of recent federal spending proposals on rural hospitals.
Author(s): Scott Hulver, Zachary Levinson, Jamie Godwin, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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Presents information and data on rural hospitals and rural hospital finances. Compares insurance coverage of discharges and births, margins, and the impact of Medicaid expansion by hospitals' rural and urban location. Includes information on rural hospital closures and Medicare special payment designations for rural hospitals. Discusses the potential impacts of recent federal spending proposals on rural hospitals.
Author(s): Scott Hulver, Zachary Levinson, Jamie Godwin, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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Medicare Beneficiary Receipt of Methadone by Drive Time to Opioid Treatment Programs
Examines availability of methadone at opioid treatment programs for Medicare beneficiaries who have been diagnosed with an opioid use disorder. Utilizes data from 640,706 Medicare beneficiaries and analyzes their respective drive time to a treatment facility as well as receipt of methadone treatment. Includes U.S. map showing locations of opioid treatment programs and rural versus urban comparisons of patient drive times.
Author(s): Jonathan Cantor, Helin G. Hernandez, Aaron Kofner, et al.
Citation: JAMA Network Open, 8(4), e253099
Date: 04/2025
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Examines availability of methadone at opioid treatment programs for Medicare beneficiaries who have been diagnosed with an opioid use disorder. Utilizes data from 640,706 Medicare beneficiaries and analyzes their respective drive time to a treatment facility as well as receipt of methadone treatment. Includes U.S. map showing locations of opioid treatment programs and rural versus urban comparisons of patient drive times.
Author(s): Jonathan Cantor, Helin G. Hernandez, Aaron Kofner, et al.
Citation: JAMA Network Open, 8(4), e253099
Date: 04/2025
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Stand-Alone Drug Plans Cover a Larger Share of Medicare Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans
Examines Medicare Part D enrollment in stand-alone Medicare prescription drug plans and Medicare Advantage drug plans in 2025. Presents data by urban, rural adjacent, and rural non-adjacent status nationally and by state.
Author(s): Juliette Cubanski, Tricia Neuman, Anthony Damico
Date: 04/2025
Sponsoring organization: KFF
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Examines Medicare Part D enrollment in stand-alone Medicare prescription drug plans and Medicare Advantage drug plans in 2025. Presents data by urban, rural adjacent, and rural non-adjacent status nationally and by state.
Author(s): Juliette Cubanski, Tricia Neuman, Anthony Damico
Date: 04/2025
Sponsoring organization: KFF
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Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations
Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment
Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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Exploring Oral Health and Care Access among Adults with Disabilities
Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Assisting Rural Consumers
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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